Colon Surgery

Dm, Gallagher; Hw, Boggs; Am, Cuthbertson; Je, Ray; Mw, Stearns; Mc, Veidenheimer

doi:10.1007/bf02586783

Cited by 2 publications

(1 citation statement)

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“…This is in agreement with the consensus of another recent panel of the American Society of Colon and Rectal Surgeons [4]. To our great relief the 3 distinguished panelists have absolved us from the onerous duty of following Dr. Turnbull's demanding technique in every detail and on every patient.…”

Section: Question 4: Which Is Your Methods For Colon Anastomoses: Singsupporting

confidence: 85%

Discussion panel on colo-rectal carcinoma

Trede¹,

Goligher²,

Hollender³

et al. 1981

Langenbecks Arch Chiv

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The incidence of colo-rectal cancer is increasing in all Western countries. Three internationally recognized experts (representing 3 different tongues) have consented to answer 11 questions on this subject in English. The moderator has attempted to summarize and comment on the various viewpoints.Question 1: Your patient has a histologically proven sigmoid carcinoma. What further preoperative examinations (IVP., total colonoscopy, etc.) would you perform as a routine?Goligher: In addition to haematology, grouping and cross-matching of blood, estimation of plasma electrolytes and urea, and chest X-ray examination, I would have a routine IVP done to show the function of both kidneys and possibly reveal any involvement of the left ureter. If the lesion in the sigmoid had been detected by sigmoidoscopy without radiological examination, the advisability of a barium enema study or colonoscopy to exclude another carcinoma or associated polyps would warrant consideration. Previously I relied on a meticulous palpation of the entire large bowel at laparotomy to detect any concomitant lesions, but, whilst this is a satisfactory method for diagnosing further carcinomas -present in 2-3 % of all cases ofcolorectal cancer -it is far from reliable in detecting soft benign polyps, which, if widely distributed, might influence the plan of operation. More recently, therefore, I have been ordering routine pre-operative double-contrast barium enema studies. Unfortunately the presence of a constricting carcinoma in the distal bowel has often made thorough preparation difficult and impaired the quality of the results. I must say that so far the yield from such radiological investigation in my experience has not really justified the inconvenience to the patient.Hollender: In the case of a proven sigmoid carcinoma, we perform as a routine an IVP, which seems to us to be a pre-operative examination of high value in that it shows the condition of the left ureter, the kidneys, and the bladder. If the latter is abnormal, we ask for a cystoscopy, but this is rare.

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Section: Question 4: Which Is Your Methods For Colon Anastomoses: Singsupporting

confidence: 85%

Discussion panel on colo-rectal carcinoma

Trede¹,

Goligher²,

Hollender³

et al. 1981

Langenbecks Arch Chiv

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Tube cecostomy and staged resection for obstructing carcinoma of the left colon

Hoffmann

Jensen

1984

Diseases of the Colon &Amp; Rectum

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Over a 17-year period, all patients presenting with acute obstruction of the left colon due to carcinoma were treated by emergency tube cecostomy. There were 57 patients aged between 35 and 93 years. After the decompressive procedure, eight died, 34 had complications, and eight were left with permanent cecostomies. Forty-one underwent secondary procedures of which 35 had resections. Seven patients died postoperatively and 15 had complications. Of the 34 survivors, in 23 the cecostomy closed spontaneously, and 11 had operative cecostomy closure. Of the latter, four died postoperatively, and nine had complications. Thus, 30 survived the entire treatment program. Reasons for the high morbidity and mortality are discussed. Comparison is made with other forms of treatment in the literature. A treatment program is suggested, using tube cecostomy for poor-risk patients and primary resection without anastomosis for patients in better condition.

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Colon Surgery

Cited by 2 publications

References 0 publications

Discussion panel on colo-rectal carcinoma

Discussion panel on colo-rectal carcinoma

Tube cecostomy and staged resection for obstructing carcinoma of the left colon

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